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Robotic Surgery Training During General Surgery Residency: A National Survey Study
Hayley Reddington1, Anna Bogursky1, Zachary Ballinger1
1Division of Thoracic Surgery, Department of Surgery, University of Massachusetts Chan Medical School, Worcester, Massachusetts.
Purpose:
To characterize current exposure to robotic surgery during United States general surgery residency and determine how specific training elements impact graduates' incorporation of robotics in early practice.
Methods:
A cross-sectional, anonymous, web-based survey was sent to recent general surgery graduates between August 2024 and January 2025. The survey underwent pilot testing before distribution. Items addressed demographics, availability and use of a structured robotic curriculum, simulator access, perceived console autonomy, and present operative practice. Counts of resident and fellow Equivalency Certificates (2020-2023) were obtained from Intuitive Surgical to contextualize trends. Descriptive statistics were performed for the full cohort. Univariate tests compared graduates who do and do not use robotics as attendings; p < 0.05 denoted significance.
Results:
Seventy-six graduates from 16 programs responded (74% attendings, 61% male). Fifty-four percent reported a formal robotic curriculum, and 66% had the opportunity to obtain an Intuitive Equivalency Certificate. Curriculum presence, Intuitive Equivalency Certificate availability, robotic emphasis, robotic exposure, autonomy in robotic cases, and perceived training level increased by graduation year. However, only 37% reported high autonomy in robotic cases overall, versus 89% and 84% for open and laparoscopic cases, respectively. Intuitive Equivalency Certificates increased more than 6-fold from 133 (2020) to 822 (2023). Among the 56 practicing attendings, 59% use robotics. Post graduate adoption was more common among males (69% versus 40%, p = 0.032), minimally invasive/colorectal/oncologic surgeons (p = 0.003), graduates rating their robotic skill "advanced/expert" (89% versus 53%, p = 0.046), and those in teaching hospitals (p = 0.017).
Conclusions:
Robotic training is expanding in general surgery residency, yet perceived autonomy remains variable. The discrepancy in autonomy across approaches and the association between gender and post graduate robotic use highlight potential gaps in training that warrant further investigation.
